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The Economic Effect of Breast Cancer in Young Women in the Republic of Panama

The Economic Effect of Breast Cancer in Young Women in the Republic of Panama

The Economic Effect of Breast Cancer in Young Women in the Republic of Panama

Author:

Myrna McLaughlin-Anderson

Program of study:

D.H.A.

Abstract:

Breast cancer is the leading cause of death among women in Panama, where 12% of
breast cancer deaths occurred in women under the age of 40. The purpose of this
quantitative correlational study was to determine the effectiveness of the interventions to
detect breast cancer in women younger than 40 years and the cost effectiveness of those
interventions in the Republic of Panama. The tools used were the Health Utility Index
(HUI) questionnaire and the EQoL-5D-3L questionnaire. The sample consisted of 125
women younger than 40 who were diagnosed with breast cancer at the National
Oncology Institute and the San Fernando Oncology Clinic. The study results revealed
approximately 50.4% of the study group used breast self-exam as the diagnostic method.
Among the participants, 19.2% had an HUI of 1, which indicated they had an excellent
quality of life and they were in a perfect health state. Of that 19.2%, 62.5% conducted
breast self-exams as a diagnostic method. The most cost effective detection strategy was
the mammogram, with a negative value incremental cost effectiveness ratio of -307.84.
Results indicated 76.0% of the sample presented some level of pain, followed by 36.8%
of the participants who indicated some level of effect in the emotion domain. Logistic
regression showed statistical significance, with the dependent variable as pain and the
independent variables as the cancer stages and the treatment modalities. A cubic
regression model indicated the cost for a quality-adjusted lived year was $19,660.16 in
2014 U.S. dollars.

I dedicate this study to my mother, Narcisa Newball de McLaughlin (QEPD), who
dedicated and devoted her entire life as a mother to transmit the values of life and the
value of education to her children. Her encouraging words remain in my daily thoughts.
To my father, Andral McLaughlin, because he took his time to teach me to read
and count, even when he was very tired. He worked diligently to provide his children
with higher education.
To my sisters, Lilia, Otilda, and Luany; and my brothers, O´Donald, Andral, and
Wallis, who were there to encourage me during my pre-graduate studies and my doctoral
journey.
To my husband, Elmer Anderson, who supported me emotionally and financially
in completing my doctoral studies, for the long hours he took being my company and
providing me encouragement.
To my son, Andral Anderson, for his support when I was tempted to give up and
for teaching me to work on the computer.
Last, to the family of Anderson Quijada, my brother-in-law, his wife, and my
nieces, thanks for your hospitality and support.

Acknowledgements:

First, my acknowledgement to God; He gave me the strength and spiritual support
to make this dream become a reality. I would like to thank my committee Chair, Dr. Jeff
Rhoades, my committee members Dr. Margaret Fitch and Dr. Francine Nelson, for the
time they took to read my draft and for the guidance they provided during this journey.
Thanks to Ms. Stella Vallarino de Stripeau for the support during the first steps of this
process. Thanks to my colleagues at the University of Panama, especially those of the
Adults Health Department, and generally to the nurse faculty members. To my close
friends, thanks for your understanding and companionship during this long process:
especially to Elmer, Andral, Joe, Julio Santamaria, Francis Palma, Gaspar DaCosta,
Marisol, and Gisela Garibaldo.
Thanks to Ms. Alicia Luaces for the official language translation. Thanks to my
colleagues and dear friends from Hospes Association of Palliative Care. Thanks to Dr.
Anibal Villa-Real from the National Oncology Institute, to Dr. Fernanda Picardy, and to
Dr. Carlos Rodriguez for the opportunity to interview the patients from your facilities.
i would like to thank many of my doctoral cohorts for providing the opportunity to learn
and practice teamwork at the university of phoenix, school of advanced studies for
providing a challenging and rewarding doctoral program. Thanks to Mr. John Horsman,
who presented my case to the health utilities board to receive grant user licensing to use
the instruments. Thanks Dr. Jin Zhenhu, throughout the process, you always encouraged
me to reach to the goal of completing the dissertation. Finally, my gratitude to those
patients that accepted to participate in the study independently of their physical or
emotional condition.